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Allison Sit

Aug 05
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Understanding Psoriasis at SOCU with Dr. Amy McMichael

By Medical Dermatology, Sessions

diagnosing and treating psoriasis in skin of color

August is Psoriasis Awareness Month. At Skin of Color Update 2024, Amy McMichael, MD, FAAD, delivered a comprehensive presentation on the unique challenges of diagnosing and treating psoriasis in patients with skin of color. She emphasized the importance of early recognition, tailored treatment plans, and addressing racial disparities in clinical research.

Unique Presentation in Skin of Color
Psoriasis often appears differently in darker skin tones, with violaceous or hypertrophic plaques, hyperpigmented thin plaques, or guttate (raindrop-like) lesions rather than the classic red, scaly plaques seen in lighter skin. Dr. McMichael recommended biopsy confirmation, especially since the appearance may evolve during treatment.

Treatment Strategies

  • Topicals: Ultrapotent topical steroids are often first-line, but non-steroidal alternatives (e.g., calcipotriene, roflumilast, tapinarof) may be used to reduce steroid-related side effects.
  • Systemics: For more severe cases, systemic treatments like methotrexate, cyclosporine, and acitretin can be effective, particularly in hypertrophic lesions.
  • Biologics: Although effective across all skin types, biologics are underutilized in patients of color due to limited representation in clinical trials.
  • JAK inhibitors and UV phototherapy were also discussed as viable options, especially for refractory disease or patients seeking non-biologic treatments.

Special Considerations
Treating areas like the scalp or groin requires attention to hairstyling practices and vehicle compatibility. Post-inflammatory hyperpigmentation (PIH) is a frequent concern in patients of color, often lingering after psoriasis clears. Dr. McMichael stressed setting realistic expectations and suggested adjunctive use of retinoids or skin-lightening agents alongside psoriasis treatments.

Addressing Disparities
Despite the broad availability of effective therapies, patients of color remain underrepresented in psoriasis research. Dr. McMichael pointed to the VISIBLE trial, which enrolled a racially diverse patient group, as a model for more inclusive studies.

Conclusion
Dr. McMichael underscored the importance of aggressive early treatment, cultural and clinical sensitivity, and diversifying clinical research to improve outcomes for patients of color. Education on pigmentary changes and tailored treatment strategies are key to managing both the physical and psychological impacts of psoriasis in diverse populations.

This session summary was written by Dr. Nidhi Shah and published on Next Steps in Derm.

Jul 30
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Cosmetic Procedures in Patients with Skin of Color: Highlights from SOCU 2024

By Sessions

cosmetic procedures in patients with skin of color

At Skin of Color Update 2024, Dr. Cheryl Burgess delivered an insightful presentation on providing safe and effective cosmetic treatments for patients with skin of color. Her talk emphasized the importance of understanding both biological and cultural differences to minimize complications and enhance outcomes.

Dr. Burgess highlighted that, while all individuals have the same number of melanocytes, patients with darker skin have larger melanosomes, increasing their risk for hyperpigmentation. She also explained how cultural beauty ideals—such as preferences for lighter skin in Southeast Asia or fuller body figures in West Africa—can shape patient expectations and treatment goals.

Histologically, skin of color differs in fibroblast structure, melanin dispersion, and vascular reactivity, making it more prone to scarring and post-inflammatory hyperpigmentation. Dr. Burgess stressed careful diagnosis using tools like a Wood’s lamp and colorimeters, and advocated for test spots and low-concentration peels to ensure safety.

She identified the Nd:YAG 1064nm laser as the safest option for hair removal and pigmentation treatment, while advising against IPL due to risks of burns. Other effective technologies include radiofrequency and ultrasound-based treatments, which require cautious use.

Finally, Dr. Burgess underscored the need for cultural sensitivity in cosmetic enhancements, such as lip augmentation preferences among Black patients and body image norms in West Africa. Her presentation called for a personalized, informed approach to cosmetic dermatology that combines clinical skill with cultural understanding.

This session summary was written by Dr. Nidhi Shah and published on Next Steps in Derm.

Jul 25
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JDD Buzz: Diversity in Melasma Clinical Trials

By SOC Manuscripts

diversity in melasma clinical trials

A recent Journal of Drugs in Dermatology study looked at the diversity of patients enrolled in melasma clinical trials to determine if there are any disparities in representation.

Read this interview with author Jared Jagdeo, MD, MS, associate professor of dermatology and director of the Center for Photomedicine at SUNY Downstate Medical Center. Learn Dr. Jagdeo’s key takeaways from the study and hear his advice for researchers in increasing representation in a study population.

Register for Skin of Color Update 2025 and learn the latest in the pathogenesis, diagnosis, and treatment of melasma.

Jul 17
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Practical Dermatology: SOCU 2024 Coverage on Minimizing Complications

By Media Coverage

minimize complications

Practical Dermatology posted an interview with Skin of Color Update Conference Co-Chair Eliot F. Battle, MD, who shares the motivation behind the conference’s launch 17 years ago. He outlines the reasons why dermatology clinicians should pursue education and training on the treatment of patients with skin of color, and how technological advances are providing new opportunities for high-quality care in this patient population.

Dr. Battle frequently addresses Skin of Color Update attendees on using laser and energy-based devices in patients with skin of color. Hear his quick tips on minimizing and treating complications, and learn how to grow your skills – and your practice – in treating patients with skin of color using devices.

Register now for Skin of Color Update 2025 and increase your knowledge of how to provide safe and effective dermatologic care for patients with skin of color.

Jul 11
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Drug Approvals in Medical Dermatology at SOCU with Andrew F. Alexis, MD, MPH

By Medical Dermatology, Sessions

drug approvals in medical dermatology

In the last few years, the FDA has granted approval to several dermatologic therapies that impact patients with skin of color. At Skin of Color Update 2024, Conference Co-Chair Andrew F. Alexis, MD, MPH, spoke with Next Steps in Derm about some of the recently approved topical, biological, and oral therapies.

Watch and learn how these newly approved treatments address conditions that disproportionately affect and burden patients with skin of color. Wonder what’s coming? Dr. Alexis shares his take on what’s ahead in the drug pipeline.

Register for Skin of Color Update 2025 for more updates in medical therapies for patients with skin of color.

Jul 02
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Laser End Points at SOCU with E. Victor Ross, MD

By Sessions

laser procedures in patients with skin of color

Safety in using lasers and other procedural treatments is a key educational focus of Skin of Color Update. At the 2024 conference, Next Steps in Derm interviewed E. Victor Ross, MD, FAAD, about his session on laser end points.

Watch as Dr. Ross shares end points for a few laser procedures and what you don’t want to see. Learn what tool Dr. Ross uses even in standard procedures to help with recognizing end points. Find out how a cooling device can be used in safely treating patients with skin of color. Hear how to protect surrounding skin when treating a lentigo. What happens if a laser doesn’t have an end point? Find out Dr. Ross’s tips on how to ensure safety and effectiveness in these situations.

Register for Skin of Color Update 2025 for more pearls in procedural treatments in patients with skin of color.

Jun 24
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Advancing Vitiligo Treatment: Highlights from SOCU 2024

By Sessions

overview of vitiligo

June is Vitiligo Awareness Month. At the 2024 Skin of Color Update, Rebecca Vasquez, MD, FAAD, of UT Southwestern Medical Center, shared a comprehensive overview of vitiligo, highlighting its significant psychological and medical impact.

Affecting 0.5% to 2% of the global population, Dr. Vasquez detailed the role of immune-mediated destruction of melanocytes, which is primarily driven by autoreactive CD8+ T cells. Environmental triggers, like sunburn or phenolic compounds, can trigger or exacerbate the condition, which often appears in areas prone to friction or trauma, such as the elbows and hands.

Clinical Types:

  • Nonsegmental Vitiligo (NSV): Most common, progressive, and often associated with autoimmune conditions.
  • Segmental Vitiligo (SV): Less common, typically stabilizes after rapid early progression.

Dr. Vasquez emphasized the emotional burden of the disease, especially in patients with skin of color, and the need to address psychological health alongside physical symptoms.

Treatment Options:

  • Topical Therapies: Corticosteroids and calcineurin inhibitors.
  • Phototherapy: Narrowband UVB (NbUVB) promotes repigmentation, especially when combined with topicals.
  • JAK Inhibitors: Topical ruxolitinib has shown strong results in trials; oral versions are in phase 3.
  • Surgical Treatments: Autologous skin cell suspension shows high repigmentation success in stable cases.
  • Combination Therapies: Approaches like ruxolitinib + NbUVB yield better outcomes.

Emerging Research:

  • Oral JAK inhibitors (ritlecitinib, povorcitinib, upadacitinib) show promise.
  • Targeting IL-15 as a way to go after tissue-resident memory T cells may offer long-term remission.

Conclusion:
There is no cure, but treatment is advancing. A personalized, multidisciplinary approach is essential to effectively manage both the physical and emotional aspects of vitiligo.

This session summary was written by Dr. Nidhi Shah and published on Next Steps in Derm.

Register for SOCU 2025 for more education on pigmentary disorders, including vitiligo.

Jun 16
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JDD Buzz: Interview with SOCU 2025 Faculty Nada Elbuluk, MD, MSc

By Medical Dermatology

patients with skin of color

Skin of Color Update faculty member Nada Elbuluk, MD, MSc, spoke with Next Steps in Derm about her recent Journal of Drugs in Dermatology study that sheds light on the most common reasons why patients of color seek outpatient dermatologic care. Dr. Elbuluk will speak at Skin of Color Update on pigmentary disorders, including hyperpigmentation and hypopigmentation.

Dr. Elbuluk and the team of researchers conducted a retrospective chart review among patients with skin of color who sought care at the USC outpatient dermatology clinics. They found that the five most common skin concerns that initiated an office visit among skin of color patients were skin examinations, evaluation of bumps/growths, rashes, acne, and skin discoloration. The five most common diagnoses dermatologists made were benign nevi/neoplasms, dermatitis, acne, eczema and/or xerosis, and dyspigmentation.  

“Some of the results were surprising in that there were differences when we stratified the results by age, gender, and racial ethnic group,” Dr. Elbuluk said. “These results showed that it’s important that we don’t homogenize all the skin of color populations and recognize that other demographic factors can also make a difference in the most common concerns and diagnoses in these populations.”

Dr. Elbuluk says understanding these concerns and diagnoses can help dermatology clinicians improve health care outcomes and equity for patients with skin of color.

Click here to read the full article on Next Steps in Derm and to read more dermatology coverage.

Register for Skin of Color Update 2025 and learn from experts like Dr. Elbuluk on how to best diagnose and treat dermatologic disorders in patients with skin of color.

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